Lecture 1: Cardiovascular & Renal Adaptations in Pregnancy Flashcards
What are adaptations required for in pregnancy?
Increase CO and BV - maintain uteroplacental perfusion and maintain metal demands
How long is human pregnancy (from last menstrual period and fertilisation)?
280 days (40 weeks)
266 days (38 weeks)
What are the physiologic adaptations to pregnancy?
Hyperdynamic, hypermetabolic, hypervolemic, hypercoaguable, low resistance, compensatory respiratory alkalemia, diabetogenic
What is the ideal weight gain in pregnancy and when does it occur?
10-13kg, with 1-2kg in first trimester and 1-2kg/month in the 2nd and 3rd trimesters
Why is there extensive cardiac and resp work during pregnancy?
Additional breast tissue and uterine muscle are major contributors of increase in cardiac and resp work
What is the importance of glucose in pregnancy?
Major energy source for fetal and placental growth
When does maternal hyperglycaemia occur?
Late gestation
Why is there increased insulin synthesis and secretion?
Increased beta cell division and size
How much blood is lost in delivery?
500-600mL vaginal
800-1200mL caeserean
When should blood volume increase?
During pregnancy to accommodate for later loss of blood
What is the % increase of BV and when does it occur?
30-50% - begins at 6 weeks and peaks at 32 weeks
What is the % increase in plasma volume?
40-50%
What is the % increase in red cells mass and when does it occur?
25-30% – begins at 10 weeks and continues until term
Why does red cell mass increase?
Increased erythropoietin and red blood cell production
Why doe physiological anaemia and hemodilution occur?
Increase in blood volume exceeds increase in red blood cells
What is the % increase of white blood cells ad when does it occur?
25-30% - increase in 1st trimester and plateau in 2nd and 3rd